Oral health is essential for overall good health and quality of life. Yet due to its high costs, those who are low- and middle-income face financial barriers to regular dental care, particularly those without coverage from employers or government programs.
Research shows those with less income, less education, older adults, and those with no insurance coverage are more likely to visit the dentist only in emergencies and not for preventative care. This can have widespread negative impacts. Poor oral health has also been associated with increased rates of chronic conditions such as diabetes and cardiovascular and lung disease. Additionally, those with dental problems often report avoiding social interactions, which can further harm their mental health and well-being.
The Government of Canada’s rollout of the Canadian Dental Care Plan will help advance health equity for low-income older adults, families with children and persons with disabilities. Wellesley Institute welcomes this program. Once fully implemented, it could help up to nine million Canadians. However, further evaluation is needed to ensure the program covers the dental care needs of all those who do not have the income and resources needed to thrive.
For example, disability advocates have raised the issue of tying plan eligibility to only those with a Disability Tax Credit Certificate. This will not capture many low-income people with disabilities who should have access to the program, as evidence shows there are a number of barriers to tax filing which leads to low uptake of tax-related benefits and credits. It also may not be enough to cover the needs of those who require dental services that fall outside of the plan’s eligible services and established fees, such as complex complete or partial dentures and extensive rehabilitation.
Historically, access to dental care in Canada has been uneven. Most people pay for services through employer-sponsored benefit plans or out-of-pocket. There is a patchwork of provincially and municipally funded programs for eligible residents without workplace or other insurance, such as the Ontario Seniors Dental Care Program and Healthy Smiles Ontario. However, these programs are inadequate to meet the demand.
The Canadian Dental Care Plan will reimburse a portion of the cost for certain dental services, covering 100 per cent of fees for those with an adjusted after-tax family income of less than $70,000, and a portion of fees for those making less than $90,000. For those with an income under what is needed to thrive – estimated by Wellesley Institute to be between $32,947 and $48,505 after tax for retired older adults, $103,032 to $136,428 for families, and $61,654 to $83,680 for single, working-age adults – the dental care program will help them save resources and bring them closer to thriving.
Barriers to thriving are preventable. The Canadian Dental Care Plan marks a turning point in access to dental care services in Canada and to health equity. Moving forward, Wellesley Institute calls on the Government of Canada to continually evaluate the program and ensure everyone without access to dental care, whether it’s due to low-income or the lack of workplace or other coverage, can access it.